Composite palmaris longus-venous flap for simultaneous reconstruction of extensor tendon and dorsal surface defects of the hand--long-term functional result.

Soft tissue loss in the dorsum of the hand resulting from trauma often involves the extensor mechanism due to its thin skin coverage. When such composite skin and extensor tendon defects occur, the wound could be reconstructed with an ipsilateral forearm venous flap with accompanying palmaris longus tendon. Eighteen dorsal finger defects in 12 patients underwent composite venous flap and tendon transfers in the acute stage. We used both Buck-Gram-cko and Tubiana's methods for objective functional assessments. With the former method, the average composite flexion, extension deficit, and total active motion were 207.2 degrees, 39.0 degrees, and 164.7 degrees, respectively. The average score was 12.1 points, which qualified for a "good" result. With Tubiana's method, the average active flexion was 4.9, and the average extension defect was 2.3. The average score was 7.2 point, which also qualified for a "good" result. Thus, a one-stage composite forearm venous flap could be used to reconstruct dorsal skin and tendon defects of the finger with a predictably good functional outcome.